In this publication our group was able to show for the first time, that patients with exercise dyspnoe or risk for pulmonary hypertension and slightly increased pulmonary arterial pressure have worse prognosis as compared to patients with lower pulmonary arterial pressure values. Mean pulmonary arterial pressure values above a threshold of 17 mmHg which were already associated with worse prognosis. This was mainly due to higher age and comorbidities. Nevertheless values above 20 mmHg were associated with a bad prognosis even after correction for these factors. This may be mainly explained by potential pulmonary vascular disease, lung diseases or left heart diseases.